New Guide on Transgender-Affirming Hospital Policies

by Tari HannemanMay 26, 2016

Last year, my friend and colleague Beck Bailey wrote about his experiences with the healthcare system after he took a bad fall while skiing. While no one relishes the idea of having to receive emergency medical care or spend time in a hospital, this is an experience that is particularly dreaded by transgender people who frequently face discrimination in healthcare settings. In fact, Lambda Legal's landmark 2010 survey, When Health Care Isn't Caring, found that 70 percent of transgender and gender-nonconforming people had experienced discrimination in healthcare.

To help combat this discrimination, the U.S. Department of Health and Human Services recently finalized rules confirming that transgender and gender nonconforming people are protected against health care discrimination under Section 1557 of the Affordable Care Act. These rules apply to both insurance coverage as well as most healthcare providers, including hospitals like the one where Beck was treated.

While Beck experienced incidences of misgendering and other types of discrimination, he also found that many providers truly wanted to be supportive, but lacked any training in LGBT patient-centered care. Furthermore, the hospital did not have any policies or procedures in place to provide welcoming and affirmative care to transgender patients. To provide guidance to hospitals and other healthcare facilities that are seeking to improve healthcare for transgender patients, HRC Foundation, Lambda Legal and the LGBT Rights Committee of the New York City Bar Association, with pro bono assistance from Hogan Lovells US, LLP, and Proskauer Rose LLP, have released an updated version of our guide, “Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies.”

When first released in November 2013, "Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies" was a pioneering document designed for all hospital personnel seeking to align themselves with best practices in transgender care. It answered their questions about transgender patients, showed them how to reduce bias and insensitivity, and addressed key issues such as confidentiality, room assignments, bathroom access, and admitting/registration procedures. The guidance also included unique model policies that could be adapted to meet the needs of individual hospitals.

The intervening years have seen a significant change in the legal landscape concerning transgender rights in the healthcare context, including victories in court, new state insurance bulletins and evolving policies and best practices, culminating in the finalized Section 1557 rules. The revised publication incorporates those changes, adds new policies and updates existing ones.

HRC Foundation’s Healthcare Equality Index (HEI) is the national LGBTQ benchmarking survey and report that helps healthcare facilities provide more equitable care to their LGBTQ patients. This year we found that only twenty-one percent of hospitals participating in the HEI 2016 had specific policies outlining procedures and practices to eliminate bias and insensitivity toward transgender patients. This revised publication will go a long way in helping more hospitals adopt crucial policies and practices to ensure that transgender patients like Beck are welcomed and treated with appropriate care.

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